Does electrocardiogram help in identifying the culprit artery when angiogram shows both right and circumflex artery disease in inferior myocardial infarction?

Objective: In a subgroup of patients with inferior myocardial infarction (MI), both the right coronary artery (RCA) and circumflex coronary artery (Cx) show potentially culprit lesions, and angiography may be insufficient to determine which artery is responsible for the clinical presentation. Although many electrocardiographic (ECG) algorithms have been proposed for identifying the infarct-related artery in patients with inferior MI, it is unclear whether the current algorithms have the discriminative power to identify the real culprit artery in these patients.

Methods: The patients with the diagnosis of acute inferior MI and underwent coronary angiography were enrolled in the study.

Is the inferior ST-segment elevation in anterior myocardial infarction reliable in prediction of wrap-around left anterior descending artery occlusion?

Objective: In a subgroup of patients with the anterior wall myocardial infarction (MI), the electrocardiogram (ECG) records a concomitant inferior ST-segment elevation (STE), which is generally explained by a 'wrap-around' left anterior descending (LAD) artery occlusion. However, recent evidence indicates that this may be due to a distal LAD occlusion, which may be irrelevant to the LAD length. We investigated the relationship between inferior ST-T changes in anterior MI and the presence of a wrap-around LAD.

[Prasugrel in clinical practice: Frequently asked questions].

This section includes evidence based short answers to frequently asked questions regarding the clinical use of prasugrel.